HyperthyroidismNRS316 - Physical Assessment

Nursing Assessment of Hyperthyroidism
Subjective data

Health Hx – present goiter, recent infection, live in an iodine-deficient area, any history of autoimmune diseases
Current medications – thyroid hormones, herbal therapies that may have the thyroid hormone
Health perception – family history of thyroid disorders or autoimmune disorders
Nutritional-metabolic – iodine intake, recent weight loss, increased appetite, thirst, n/v
Elimination – diarrhea, polyuria, sweating
Activity/exercise – DOE, palpitations, muscle weakness, fatigue
Sleep-rest – insomnia
Cognitive-perceptual – angina, nervousness, heat intolerance, pruritis
Sexuality-reproductive – decreased libido, impotence, amenorrhea, gynecomastia
Coping-stress tolerance – emotional lability, irritability, restlessness, personality changes, delirium

Objective data

Observation – agitation, rapid speech and body movements, anxiety, restlessness, hyperthermia, enlarged thyroid
Eyes – eyelid retraction, infrequent blinking, exophthalmos
Integumentary – warm, diaphoretic, velvety skin, thin and loose nails, fine and silky hair and hair loss, palmar erythema, clubbing, white pigmentation of the skin, diffuse edema of legs and feet
Respiratory – tachypnea, DOE
Cardiovascular – tachycardia, bounding pulse, systolic murmurs dysrhythmias, hypertension, bruit over the thyroid gland
GI – increased bowel sounds, increased appetite, diarrhea, weight loss, hepatosplenomegaly
Neurologic – hyperreflexia, diplopia, fine hand tremors, and tremors of the tongue and eyelids
Musculoskeletal – muscle wasting
Reproductive – menstrual irregularities, infertility, impotence
Diagnostic findings – increased T3, T4, and T3 resin uptake, decreased or undetectable TSH, chest x-ray showing an enlarged heart, ECG findings of tachycardia or atrial fibrillation